A unanimous three-judge panel of the N.C. Court of Appeals ruled this morning against Taylortown in the lawsuit pitting the town against former police chief Timothy Blakely. Appellate judges upheld most of a lower-court ruling favoring Blakely. The only part of the appellate decision that favors the town is a ruling that a judgment of more than $100,000 for Blakely should be reduced by about $5,800.
Of the plans that states have hatched for the Affordable Care Act, none has been bolder than that of Vermont, which wants to implement a single-payer health-care system, along the lines of what you might find in Britain or Canada. One government-operated system will cover all 620,000 of Vermont’s citizens. The hope is that such a system will allow Vermont to get costs down closer to Canada’s, as well as improve health by coordinating care and ensuring universal coverage.
Just two small issues need to be resolved before the state gets to all systems go: First, it needs the federal government to grant waivers allowing Vermont to divert Medicaid and other health-care funding into the single-payer system. And second, Vermont needs to find some way to pay for it. …
… Vermont is a middling-tax state, as states go. And that’s not an accident; its population consists of longtime Vermonters, some of whom vote Republican (at least for governor) and are not super-tax-friendly, and transplants from Massachusetts and New York state, who, last time I looked, had moved to Vermont partly because the taxes were lower. Paying for this program would likely make Vermont the highest-taxed state in the nation, by quite a lot.
Now, you can argue that people should be glad to make this trade-off, not just for peace of mind, but because they will trade higher taxes for lower (no) insurance premiums. You can also argue that poor people in America should be laughing and dancing and singing all day because every one of them is economically better off than starving farmers in drought-ridden regions of Africa. Neither argument will do you much good, however, because that’s not how people think.
Mainstream media reporters who refuse to genuflect in the presence of The One have faced a rude awakening, as former CBS reporter Sharyl Attkisson recounted recently for Fox News. The Daily Caller offers details.
Former CBS reporter Sharyl Attkisson accused the White House of running an unprecedented pressure campaign against journalists, claiming they are pursuing a “particularly aggressive, well-organized” strategy “designed to have some kind of a chilling effect” on the American press.
Attkisson spoke with Fox News’ Howard Kurtz on Sunday about her early departure from CBS and her battles with the Obama administration for access to information. An investigative reporter who covered White House bugbears like Benghazi and Fast and Furious, she left CBS before her contract expired because she felt network executives inappropriately shot down her stories.
But in her conversation with Kurtz, Attkission made it clear that she ultimately blames the Obama administration itself for her bosses’ timidity.
“I think any journalist who has been covering Washington for a few years would agree… that there is pressure coming to bear on journalists for just doing their job in ways that have never come to bear before,” she began.
“There have always been tensions, there have always been calls from the White House — under any administration, I assume — when they don’t like a particular story,” she admitted. “But it is particularly aggressive under the Obama administration, and I think it’s a campaign that’s very well organized and designed to have sort of a chilling effect.”
“And to some degree,” she continued, “has been somewhat successful in getting broadcast producers who don’t really want to deal with the headache of it. Why put on the controversial stories that we are going to have to fight people on when we can fill the broadcast with other perfectly decent stories that don’t ruffle the same feathers?”
[T]he Congressional Budget Office estimates that about 8 million people will join the government health insurance program for the poor in 2014. By the end of February, more than 3 million had signed up.
That’s good news for patients such as [patient Sonya] Lott and for nonprofit clinics like the one in Yakima that often treat people who previously had no way to pay. The effect on the rest of the health-care system is less certain. Most doctors in private practice lose money on Medicaid patients, because the program pays less than commercial health plans or Medicare, the federal insurance program for Americans over 65. Many physicians already don’t accept Medicaid, and millions of new enrollees clamoring for appointments will strain those who do. “There are concerns, as there have been for quite some time, about making sure there are enough providers to meet the needs,” says Rachel Garfield, senior researcher at the Kaiser Family Foundation, a health policy group. …
… About 46 percent of physicians accept Medicaid, according to a 15-city survey last year by staffing firm Merritt Hawkins. That’s down about 10 percent from four years before. To encourage primary-care doctors to take Medicaid patients, the Affordable Care Act has temporarily increased the program’s payments to doctors, matching Medicare’s higher rates through 2014. But the boost doesn’t apply to specialists such as cardiologists and oncologists. “What they pay doesn’t even come close to covering expenses,” says Pat Howery, the administrator at Colorado West Otolaryngologists, an ear, nose, and throat clinic in Grand Junction. For a basic office visit, Howery says, UnitedHealth Group (UNH) pays $119 and Medicare $73; Medicaid comes in at $52. “You can’t make this up in volume,” he says. In January the clinic began limiting each doctor to two Medicaid appointments a day.
In rural Yakima County, where one in five people live below the poverty line, some specialists are already overloaded with Medicaid patients. “The question is, at what point will they start saying no?” says Rhonda Hauff, chief operating officer of Yakima Neighborhood Health Services. The clinic refers several patients a week to specialists outside the county because they can’t get appointments locally, she says.
The latest Bloomberg Businessweek offers a good example of the conventional (left-of-center) wisdom about U.S. Chief Justice John Roberts. Once praised for his questionable vote to preserve the Affordable Care Act, Roberts now draws fire for a vote to end dubious aggregate campaign contribution limits.
It turned out that both sides read too much into Roberts’s performance in the [Obamacare] case. He exercised canny statesmanship to avoid a clash over Obama’s signature legislation—the sort of showdown that could have stirred a backlash against the court. Roberts accomplished this with subtle lawyering. He said Congress lacked authority under the Constitution’s Commerce Clause to impose the law’s insurance mandate but then rescued the law by declaring it passed muster as a form of taxation. Roberts’s quirky definition of the mandate as a tax likely won’t have lasting jurisprudential impact. His narrow reading of the Commerce Clause, on the other hand, could well resurface in other cases as a potent tool to undercut regulatory statutes. What many saw as a conservative defeat thus in the long run might be the opposite.
In 2013, Roberts returned to a more straightforward position as leader of the conservative wing in rulings limiting the reach of voting-rights protections and affirmative action in higher education. Now it was conservatives who praised his rigor and liberals who shook their heads. Greenhouse declared that “the real John Roberts” had revealed himself. She described his majority opinion in the voting-rights case as demonstrating a “sweeping disregard of history, precedent, and constitutional text … startling for its naked activism.” A less fraught way of describing the same decision is that the conservative justices compelled Congress to revisit the half-century-old Voting Rights Act and justify continued federal oversight of historically segregationist Southern states.
This month’s campaign-finance ruling marks another step in Roberts’s calibrated campaign to assert conservative priorities via the court. Building on the 2010 ruling in Citizens United, which struck down limits on independent campaign spending by corporations and unions, his opinion finds that the only legitimate basis for constraining campaign cash is to prevent outright greenbacks-in-the-briefcase bribery. Yet Roberts chose not to follow this line of reasoning to its logical conclusion: He declined a call by Justice Thomas in a concurring opinion to throw out the entirety of existing campaign-finance law. That task, the politically astute chief justice implied, can await another day.
No one would confuse Bloomberg Businessweek with right-of-center publications such as National Review or the Weekly Standard. That’s why it’s particularly interesting to see an editorial in the latest Businessweek with kind words about U.S. Sen. Richard Burr’s health care reform proposal.
Louisiana Governor Bobby Jindal has offered an alternative to Obamacare. His blueprint follows a plan initiated by Republican Senators Richard Burr, Tom Coburn, and Orrin Hatch in January. More such GOP proposals are expected to emerge. …
… More proposals from conservatives are to be welcomed. This is not because they could be used to upend the law—it makes no sense to start over from scratch—but because they may contain strategies to improve on the Affordable Care Act. Jindal’s plan includes two excellent ideas. The first is to let nurse practitioners and other medical professionals practice to the full extent of their abilities. This makes sense because it would drive down costs. He also proposes ending the exemption from taxes for health-care benefits provided by employers, an accident of history that encourages higher consumption of health care and makes it more expensive. Obamacare will tax high-cost plans starting in 2018; Jindal wants to scrap the exclusion altogether, replacing it with a tax deduction for all health insurance.
That would be a far-reaching change: It could signal the end to the widespread practice of obtaining insurance at work. The status quo, on the other hand, is peculiarly unfair. Americans with employer insurance get the benefit of a tax break while those who buy policies on their own do not.
A good idea from Burr and company is to automatically enroll in health-insurance plans Americans who are eligible for premium tax credits. At first glance, 7.1 million people signing up for exchange-based coverage might suggest that auto-enrollment is a solution to a problem that no longer exists. But with more than 30 million Americans projected to lack insurance even with Obamacare, there’s more to be done.
The federal Affordable Care Act address American health care challenges largely by aiming to boost the number of people with health insurance. But that approach ignores a key question: How risky is it be uninsured?
Dr. Chris Conover, research scholar at Duke University’s Center for Health Policy and Inequalities Research, addressed that question during a presentation today to the John Locke Foundation’s Shaftesbury Society. The bottom line: A lack of insurance is not as risky as you might fear.
In the video clip below, Conover summarizes key findings from his research.
3 p.m. update: Click play below to watch the full 45:30 event.
You’ll find other John Locke Foundation video presentations here.